Individual provider Active NPI

Wayne Christopher Smith, R.N.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1609055607
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC15629 Issued in CA
Practice address
229 20TH St
Apt.C
San Diego, CA 92102-3845
Phone
(619) 546-7927
Fax
(619) 546-7927
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 534727 CA
Chiropractor 111N00000X DC15629 CA Primary

Addresses

Primary practice location

229 20TH St
Apt.C
San Diego, CA 92102-3845

Mailing address

229 20TH St
Apt.C
San Diego, CA 92102-3845
Phone (619) 546-7927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
DC15629CAMDChiropractor
534727CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1609055607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 20TH ST",
            "address_2": "APT.C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921023845",
            "telephone_number": "619-546-7927",
            "fax_number": "619-546-7927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 20TH ST",
            "address_2": "APT.C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921023845",
            "telephone_number": "619-546-7927",
            "fax_number": "619-546-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WAYNE",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "534727",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC15629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.